NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which defense mechanism is considered a conscious measure used to cope with anxiety?
- A. Undoing
- B. Projection
- C. Suppression
- D. Intellectualization
Correct answer: C
Rationale: The correct answer is Suppression. Suppression is a conscious defense mechanism in which an individual intentionally avoids thinking about disturbing problems, wishes, feelings, or experiences. It is a way to cope with anxiety by actively pushing aside unwanted thoughts or emotions. Undoing, on the other hand, is an unconscious defense mechanism where one uses words or behaviors to symbolically make amends for unacceptable thoughts or actions. Projection is also an unconscious defense mechanism involving falsely attributing one's own unacceptable impulses to others. Intellectualization, another unconscious defense mechanism, involves using intellect or thinking to avoid dealing with emotionally charged feelings.
2. Your patient has been confused for years. Your patient can be best described as having a chronic ___________ disorder.
- A. physical
- B. psychotic
- C. thinking
- D. palliative
Correct answer: C
Rationale: Patients who experience long-term confusion often have a chronic thinking, or cognitive, disorder. Alzheimer's disease is a prime example of a disorder that results in prolonged confusion and memory loss. Choice A, 'physical', is incorrect as the issue described is related to cognitive functioning, not physical health. Choice B, 'psychotic', refers to a severe mental disorder characterized by a loss of contact with reality, which is not the primary issue presented in the scenario. Choice D, 'palliative', is not relevant as it pertains to specialized medical care for individuals with serious illnesses, focusing on providing relief from symptoms and stress rather than managing chronic confusion.
3. A client at a local university claims to be the president of the university. Which type of delusion is the client displaying?
- A. Somatic
- B. Grandiose
- C. Erotomanic
- D. Persecutory
Correct answer: B
Rationale: The correct answer is 'Grandiose.' This type of delusion involves an exaggerated sense of self-importance, where the individual believes they are a prominent figure or possess special abilities. In this scenario, the client claiming to be the president of the university is displaying grandiose delusions. Somatic delusions relate to bodily functions or sensations, which are not present in this case. Erotomanic delusions involve the fixed belief that another person is in love with the individual, which is not applicable here. Persecutory delusions involve the belief that one is being targeted or conspired against, which is also not demonstrated in the given situation.
4. What is the primary purpose served when an individual takes action to reduce anxiety?
- A. Reduction of tension
- B. Denial of the situation
- C. Avoidance of physical discomfort
- D. Resolution in decision-making
Correct answer: A
Rationale: The primary purpose of taking action to reduce anxiety is to alleviate emotional tension and prevent the exacerbation of anxiety symptoms. By reducing tension, anxiety levels decrease, leading to a sense of comfort, safety, and security. Denial of the situation is not the goal when addressing anxiety; rather, acknowledging and managing it is crucial. While physical discomfort may accompany anxiety, the focus is on alleviating the emotional aspect to mitigate physical manifestations. Although mild anxiety can sometimes improve decision-making skills, higher levels of anxiety typically impede cognitive functions, making resolution in decision-making less likely.
5. A client who is newly diagnosed with multiple sclerosis is obviously upset and asks, 'Am I going to die?' Which response would the nurse make?
- A. Most individuals with your disease live a normal life span.
- B. Is your family here? I would like to explain your disease to all of you.
- C. The prognosis varies, as most individuals have remissions and exacerbations.
- D. Why don't you speak with your health care provider to get more details?
Correct answer: C
Rationale: The most appropriate response to the client's question regarding their prognosis is to acknowledge the variable nature of multiple sclerosis by stating that 'The prognosis varies, as most individuals have remissions and exacerbations.' This response provides realistic information while offering some hope. Choice A ('Most individuals with your disease live a normal life span.') gives false reassurance as repeated exacerbations may affect life span. Choice B ('Is your family here? I would like to explain your disease to all of you.') does not directly address the client's question and involves the family unnecessarily. Choice D ('Why don't you speak with your health care provider to get more details?') deflects the responsibility and does not address the client's immediate concerns about their prognosis.
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